Efficacy of a home-based intervention programme on the physical activity level and functional ability of older people using domestic services: A randomised study
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Our main objective was to assess whether a home-based program supervised by home helpers (HH) during their normal working hours can prevent excessive sedentariness (mainly maximum walking time and distance) and preserve functional status in elderly people at risk for frailty or disability and using domestic services.
A four-month, open label, randomised trial with two groups called “prevention” and “control”.
In the homes of study participants.
The participants were all over 78 years old, lived independently at home, and received the visits of HHs at least once a week.
The intervention combined a self-administered exercise program, with 10 g amino-acid supplementation under the supervision of HHs.
Main outcome measures included physical activity (the PASE questionnaire), functional tests, nutritional and autonomy scores, and compliance (50% or more was considered satisfactory). Non-parametric methods were used for comparisons between the two groups. A linear regression model was fitted to assess the effect of the intervention on the relative variation of outcomes, adjusted for unbalanced baseline co-variables.
One hundred and two persons (prevention n=53, control n=49) with a median age of 85 years were included. Their median Activities of Daily Living and Instrumental Activities of Daily Living (LADL) scores were 6 and 7 respectively. Twenty-three (44%) were good compilers for both interventions. The maximum walking time remained stable while decreasing by 25% in the control group (p=0.0015); and fewer participants had a worsened IADL score in the prevention group (p=0.05). The baseline IADL Score was significantly associated with good compliance to the prevention program (p=0.0011). In good compliers, maximum walking distance and maximum walking time increased by 29.15% (0.0 to 66.7) and 33.3% (−20.0 to 50.0) respectively.
This study confirms the feasibility of a prevention program supervised by HHs, and some benefit from the intervention and identifies predictors for better compliance. It will help in the design of prevention trials for elderly people at risk for frailty.
KeywordsFrail elderly exercise aging physical activity intervention home based intervention
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- 17.Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M (2010) Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39(4):412–423.PubMedCrossRefGoogle Scholar
- 19.Manini TM, Everhart JE, Anton SD, Schoeller DA, Cummings SR, Mackey DC, Delmonico MJ, Bauer DC, Simonsick EM, Colbert LH, Visser M, Tylavsky F, Newman AB, Harris TB (2009) Activity energy expenditure and change in body composition in late life. Am J Clin Nutr 90(5):1336–1342.PubMedCrossRefGoogle Scholar
- 22.Johansson G, Eklund K, Gosman-Hedstrom G (2009) Multidisciplinary team, working with elderly persons living in the community: a systematic literature review. Scand J Occup Ther 1–16.Google Scholar
- 23.Ashworth NL, Chad KE, Harrison EL, Reeder BA, Marshall SC (2005) Home versus center based physical activity programs in older adults. Cochrane Database Syst Rev 25(1):CD004017.Google Scholar
- 26.Abellan Van Kan G, Rolland Y, Andrieu S, Vellas B, (2009) Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an international academy on nutrition and ageing (IANA) task force. JNHA 13,881–889.Google Scholar
- 29.Guigoz Y, Lauque S, Vellas BJ (2002) Identifying older people at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 18(4):737–757.Google Scholar
- 31.Centre Informatique sur la Qualité des Aliments (CIQUAL) (1991) Répertoire Général des Aliments. Table de composition, 1st edition. Éditions Tec & Doc Lavoisier et INRA Éditions, Paris.Google Scholar
- 33.Posiadlo D, Richardson S (1991) The timed “Up and Go:’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148.Google Scholar
- 34.Tinetti ME et al. (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr 34(2):119–126.Google Scholar
- 35.PASE Physical Activity Scale for older people. Administration and scoring manual. (1991) New England Research Institutes. Inc.Google Scholar
- 53.Pahor M, Blair SN, Espeland M, Fielding R, Gill TM, Guralnik JM, Hadley EC, King AC, Kritchevsky SB, Maraldi C, Miller ME, Newman AB, Rejeski WJ, Romashkan S, Studenski S. (2006) Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. J Gerontol A Biol Sci Med Sci 61(11):1157–1165.PubMedCrossRefGoogle Scholar
- 54.Katula JA, Kritchevsky SB, Guralnik JM, Glynn NW, Pruitt L, Wallace K, Walkup MP, Hsu FC, Studenski SA, Gill TM, Groessl EJ, Wallace JM, Pahor M (2007) Lifestyle interventions and independence for elders pilot study: recruitment and baseline characteristics. J Am Geriatr Soc 55(5):674–683.PubMedCrossRefGoogle Scholar
- 56.Landi F, Abbatecola AM, Provinciali M, Lattanzio F (2010) Moving against frailty: does physical activity matter? Bio gerontology 11:537–545.Google Scholar
- 57.Thompson PD, Buchner D, Pina II, Balady GJ, Williams MA, Marcus BH et al. (2003) Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the council on clinical cardiology (subcommittee on exercise. rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). Circulation 107:3109–3116.PubMedCrossRefGoogle Scholar